Achilles Tendon Rupture
SUMMARY
Causes
- High force or impact to the ankle or heel
- Fast acceleration from a stationary position
- Usually seen in patients between 30-40
Symptoms
- Sudden pain in the heel and back of the ankle at the point of injury
- An audible ‘snap’ in the heel
- Increased pain levels in activity
- Swelling and tenderness
- Limping and an inability to bear weight on the heel
Treatment
- RICE method
- Use of crutches or plaster cast
- Physiotherapy
- Surgery
What is Achilles Tendon Rupture?
The Achilles tendon is the soft tissue located in the heel which connects calf muscle to the heel bone allowing the body to perform certain activities such as rising on the tip toes and pushing off when running or walking. Achilles tendon tears occur when the tendon becomes torn through excessive pressure put on the area which the tendon is unable to withstand. Tears are most commonly found when suddenly accelerating from a standing position and therefore is often seen in runners and athletes involved in racquet sports.
A tear can also occur when a continuous force is being put on the heel through prolonged levels of activity and overuse however this can also occur as a result of sudden impact or force to the area common in contact sports such as rugby and hockey. Although Achilles tendon tears can range in their severity, a rupture is the most serious form of tear and involves a completely torn tendon. This injury is more common in patients in their 30’s and 40’s.
Achilles Tendon Rupture Symptoms
The most common symptom of Achilles tendinitis is a sudden surge of pain in the heel and back of the ankle at the point of injury which is often described as a snapping sensation in the heel. After the injury has occurred, patients then struggle or find it near impossible to bear any weight on the affected leg. Pain can often be most prominent first thing in the morning after the injury has been rested. Swelling and tenderness is also likely to appear in the area.
Achilles Tendon Rupture Diagnosis
In order to diagnose Achilles tendon rupture a doctor or physiotherapist will give a full examination of the area and sometimes an X ray is performed in order to confirm the diagnosis. A doctor may also recommend an MRI or CT scan is used to rule out any further injury or complications.
Achilles Tendon Rupture Treatment
In order to treat Achilles tendon rupture, rest is crucial to allow the injury chance to heal. It is important that no activity which increases pain or puts added pressure on the area is undergone to prevent further injury or increasing the healing period.
Surgery is often required to correct this injury and can ensure that the heel returns back to its normal function.
Having the injury set in plaster cast and/or using crutches is also recommended to keep the area immobilised and to prevent weight being put on the injury allowing the tendon to heal more effectively.
Once the injury is in its final stages of the healing process the patient can begin to take gradual steps back to activity which can involve an increase in weight bearing activity and strengthening exercises advised by a physiotherapist to keep the area strong and ensure flexibility once the patient has made a full recovery and is able to return to sports. This is a crucial part of the healing process as it is common for the tendon to become shortened during the initial resting period as it attempts to reattach itself. This should not be done without professional advice as a patient can run the risk of aggravating the area and increase the period of healing. Within the first few months of returning to training, stretching exercises may be performed to keep the area stable and strong and can also help prevent the injury reoccurring.
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